Thyroid Function and Anti-thyroid Antibodies in Pediatric Anti-NMDAR Encephalitis

Objective: Recent studies found that changes of thyroid antibodies (ATAbs), thyroid hormone, and non-thyroidal illness syndrome (NTIS) characterized by thyroid hormone inactivation with low triiodothyronine and high reverse triiodothyronine followed by suppressed thyroid-stimulating hormone (TSH) in adult anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis were associated with disease severity. This study aimed to explore thyroid function and ATAbs in pediatric anti-NMDAR encephalitis and their clinical association.Methods: We retrospectively analyzed the clinical data of 51 pediatric cases with anti-NMDAR encephalitis hospitalized in Guangzhou Women and Children's Medical Center from August 2016 to 2019.Results: A percentage of 52.9% of patients belonged to the ATAb (+) group, with 26 cases both positive for anti-thyroid peroxidase antibodies (TPOAb) and anti-thyroglobulin antibodies (TGAb), and one patient only positive for TPOAb. A percentage of 62.7% of patients had at least one abnormality in terms of FT3, free thyroxin (FT4), or TSH levels. Meanwhile, 45.1% of patients were diagnosed with NTIS. Among 25 cases retested for thyroid function 2 months after the initial test, the respectively decreased FT3 and FT4 in 13 and 11 cases on admission returned to normal or closer normal than before; TPOAb in eight cases and TGAb in 12 cases were changed from positivity to negativity. Compared with onset, the level of TPOAb and TGAb at relapse remained stable or significantly decreased, respectively. Compared with the ATAb (–) group, the ATAb (+) group had an older onset age, a higher ratio of movement disorders, elevated rate of sleep disorders, increased anti-nuclear antibody positivity rate, and higher ratio of more than one course of intravenous immunoglobulin treatment. There were no significant differences between the NTIS and non-NTIS groups in clinical characteristics.Conclusion: Anti-thyroid antibody positivity, abnormality of FT3, FT4, or TSH levels and NTIS are frequent in pediatric anti-NMDAR encephalitis. Thyroid antibody and thyroid hormone abnormalities could be improved through the course of treatment of anti-NMDAR encephalitis. Cases with ATAbs (+) are at older onset ages and more likely to be treated by intravenous immunoglobulin therapy more than once. Unlike adult anti-NMDAR encephalitis, NTIS might not be associated with the clinical characteristics of anti-NMDAR encephalitis in pediatric patients.

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EFFECT OF THYROID STATUS ON THE THYROTROPHIN-RELEASING HORMONE-DEGRADING ACTIVITY OF RAT SERUM

Journal of Endocrinology ◽

10.1677/joe.0.0710013 ◽

1976 ◽

Vol 71 (1) ◽

pp. 13-19 ◽

Cited By ~ 22

Author(s):

N. WHITE ◽

S. L. JEFFCOATE ◽

E. C. GRIFFITHS ◽

K. C. HOOPER

Keyword(s):

Thyroid Hormone ◽

Human Serum ◽

Thyroid Function ◽

Thyroid Status ◽

Rat Serum ◽

Thyrotrophin Releasing Hormone ◽

Releasing Hormone ◽

Tsh Levels

SUMMARY The TRH-degrading activity of rat serum in vitro is five times more potent than that of human serum. In rats, it is significantly reduced in hypothyroidism (thiouracil-induced) and significantly increased in hyperthyroidism (T3 or T4-induced). This suggests a possible role in the regulation of adenohypophysial-thyroid function which is probably, in turn, dependent on thyroid hormone, rather than TSH, levels.

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Urinary Iodine and Thyroid Antibodies in Okinawa, Yamagata, Hyogo, and Nagano, Japan: The Differences in Iodine Intake Do Not Affect Thyroid Antibody Positivity.

Endocrine Journal ◽

10.1507/endocrj.45.797 ◽

1998 ◽

Vol 45 (6) ◽

pp. 797-803 ◽

Cited By ~ 24

Author(s):

KOJI NAGATA ◽

NOBUYUKI TAKASU ◽

HIROMITSU AKAMINE ◽

CHIKARA OHSHIRO ◽

ICHIRO KOMIYA ◽

...

Keyword(s):

Urinary Iodine ◽

Iodine Intake ◽

Thyroid Antibodies ◽

Thyroid Antibody ◽

Antibody Positivity

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Thyroid Antibodies and Miscarriage: Where Are We at a Generation Later?

Journal of Thyroid Research ◽

10.4061/2011/841949 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 21

Author(s):

Alex Stagnaro-Green

Keyword(s):

Pregnancy Loss ◽

Future Research ◽

Thyroid Antibodies ◽

Recurrent Abortion ◽

Initial Finding ◽

Research Directions ◽

Thyroid Antibody ◽

Spontaneous Miscarriage ◽

Antibody Positivity ◽

Future Research Directions

In 1990, an association between thyroid antibody positivity and spontaneous miscarriage was first reported. A generation has passed since the initial observation. Over that time a robust literature has developed which has confirmed the initial finding and expanded upon it. The present paper reviews the literature that has been generated over the last twenty years on the following topics: (1) thyroid antibodies and spontaneous miscarriage, (2) thyroid antibodies and recurrent abortion, (3) etiology of pregnancy loss in thyroid antibody positive women, and (4) discussion of future research directions.

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Impact of thyroid cancer treatment on assisted reproductive technology outcomes in women with infertility

Journal of Assisted Reproduction and Genetics ◽

10.1007/s10815-021-02204-2 ◽

2021 ◽

Author(s):

Ning Huang ◽

Lin Zeng ◽

Jie Yan ◽

Hongbin Chi ◽

Jie Qiao

Keyword(s):

Thyroid Cancer ◽

Live Birth ◽

Clinical Pregnancy ◽

Birth Rates ◽

Thyroid Antibody ◽

Live Birth Rates ◽

Antibody Positivity ◽

Partial Thyroidectomy ◽

Icsi Outcomes ◽

Tsh Levels

Abstract Purpose We investigated the effect of different surgical procedures and radioactive iodine treatment (RAIT) on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes and evaluated whether possible risk factors, including age, thyroid-stimulating hormone (TSH) levels, and thyroid antibody positivity, were associated with adverse IVF/ICSI outcomes. Methods This retrospective study included 76 women with infertility who had received thyroid cancer (TC) treatment among 137,698 infertile women who underwent IVF/ICSI cycles at the Peking University Third Hospital between 2010 and 2019. Clinical pregnancy and live birth rates were assessed. Results We found that the clinical pregnancy and live birth rates in women who underwent partial thyroidectomy were 7- and 6-fold higher, respectively, than those in women who underwent total thyroidectomy. We observed no significant differences in the clinical pregnancy and live birth rates between the RAIT and non-RAIT groups, even after adjusting for age, TSH levels, surgical treatment, and thyroid antibody positivity. Multivariate logistic regression analysis showed that age and TSH levels were not associated with decreased clinical pregnancy and live birth rates. Women with thyroid antibody positivity had significantly lower clinical pregnancy and live birth rates than women without thyroid antibody positivity. Conclusion Our study showed lower clinical pregnancy and live birth rates in women who underwent total thyroidectomy than in women who underwent partial thyroidectomy. Thyroid antibody positivity is an important risk factor for adverse IVF/ICSI outcomes in women who have received TC treatment.

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Are Changes in Thyroid Hormones Associated with Mortality in Non-Thyroidal Illness Syndrome?

European Journal of Clinical Medicine ◽

10.24018/clinicmed.2021.2.6.148 ◽

2021 ◽

Vol 2 (6) ◽

pp. 56-59

Author(s):

Emre Hoca ◽

Hayriye Esra Ataoğlu ◽

Süleyman Ahbab

Keyword(s):

Thyroid Hormone ◽

Thyroid Function ◽

Acute Phase ◽

Mortality Data ◽

Thyroid Function Tests ◽

Hormone Levels ◽

Function Tests ◽

Thyroid Hormone Levels ◽

Tsh Levels

Introduction: Non-thyroidal illness syndrome (NTIS) can be defined as afunctional impairment of the hypothalamic-pituitary-thyroid axis accompanied by signs of non-thyroidal disease with changes in thyroid stimulating hormone (TSH), free T3 (fT3) and free T4 (fT4) levels. NTIS and thyroid hormone levels in this syndrome are thought to be related with mortality. This study was performed to evaluate the relationship between hormone levels and mortality in this syndrome. Methods: The 5-year mortality data of patients who were hospitalized in the first 6 months of 2014 and whose thyroid hormone levels could be checked twice within 5 years were evaluated. In our study conducted with 405 patients whose thyroid function tests was repeated, the follow-up period was 5 years. Biochemical parameters including thyroid function tests were sent from all patients. NTIS was defined as a condition in patients with low fT3 levels (<2.5 pg/mL) and TSH levels within the normal range (0.38-5.33 mIU / L). Results: 128 patients died, and the number of surviving patients was 277 during the follow-up period. Positive acute phase reactants such as CRP, sedimentation, ferritin was high and albumin (negative acute phase reactant) and fT3 levels were low in patients who died. In addition, these changes in biochemical values were statistically significant. The mortality rate was increased in patients with low fT3 and high fT4 levels. In the follow-up period, changes in TSH levels were not significantly associated with mortality. Conclusion: Both the decrease in fT3 levels and the increase in fT4 levels can be used as predictors and independent risk factors for long-term mortality risk in chronically ill and hospitalized patients with NTIS.

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Association between thyroid dysfunction and type 2 diabetes: a meta-analysis of prospective observational studies

BMC Medicine ◽

10.1186/s12916-021-02121-2 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Fen Rong ◽

Hongji Dai ◽

Yuwan Wu ◽

Jibin Li ◽

Guoping Liu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Thyroid Hormone ◽

Thyroid Function ◽

Prospective Studies ◽

Meta Analysis ◽

Cubic Spline ◽

Current Evidence ◽

Tsh Levels

Abstract Background Diabetes mellitus and thyroid disease are two areas of broad interest in the field of endocrinology and metabolism. Variation of thyroid hormone concentration, even within the normal range, may portend the onset of type 2 diabetes mellitus (T2DM), especially among those with prediabetes. However, current evidence is mixed. Methods Prospective studies which assessed diabetes incidence were identified using a database search of MEDLINE and Embase through May 1, 2021. The Sidik-Jonkman random-effects model and cubic spline model were used to evaluate the associations and dose-response relationships between thyroid function/hormone levels and risk of T2DM and cardiovascular disease (CVD) risk among T2DM patients. Results A total of 12 prospective studies were included. We found that high baseline TSH levels were related to a 17% higher risk of T2DM (RR 1.17, 95% CI 1.01, 1.36; I2=78%, P<0.01), compared with normal TSH levels. Low FT3 (RR 1.40, 95% CI 1.09, 1.80; I2=59%, P=0.03) and low FT4 (RR 1.33, 95% CI 1.04, 1.71; I2=62%, P=0.02) levels were significantly associated with risk of T2DM. The cubic spline model indicated a J-shaped relationship with TSH, but inverted-J-shaped relationships with FT3 and FT4. CVD events and all-cause deaths were prospectively evaluated in four studies, but were not associated with abnormal thyroid function. Conclusions Our meta-analysis determined that abnormal thyroid hormone level is associated with an increased risk of T2DM, showing a J-shaped relationship with TSH and inverted-J-shaped relationships with FT3 and FT4. Trial registration Registered number in PROSPERO: CRD42021225695.

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Increased sensitivity to the inhibitory effect of excess iodide on thyroid function in patients with beta-thalassemia major and iron overload and the subsequent development of hypothyroidism

Acta Endocrinologica ◽

10.1530/eje.0.1430319 ◽

2000 ◽

pp. 319-325 ◽

Cited By ~ 14

Author(s):

T Alexandrides ◽

N Georgopoulos ◽

S Yarmenitis ◽

AG Vagenakis

Keyword(s):

Thyroid Hormone ◽

Iron Overload ◽

Thyroid Function ◽

Subclinical Hypothyroidism ◽

Beta Thalassemia ◽

Normal Response ◽

Normal Thyroid ◽

Increased Sensitivity ◽

Excess Iodide ◽

Tsh Levels

OBJECTIVE: Patients with beta-thalassemia frequently develop primary hypothyroidism and other endocrine disorders due to iron overload. We studied whether administration of excess iodide to patients with apparently normal thyroid function could uncover an underlying thyroid disease. DESIGN AND METHODS: Twenty-five patients, 10 prepubertal (mean age 11+/-3 years) and 15 adults (mean age 23+/-5 years) with normal thyroid hormone and TSH levels, a normal response of TSH to TRH and negative thyroid peroxidase antibodies received 20mg iodide three times daily for three weeks, and thyroid hormone and TSH levels were measured weekly during, and for three weeks after, iodide administration and every 3 months thereafter for the next 5 years. RESULTS: During iodide administration there was a significant decrease in thyroid hormone concentrations which remained within normal levels, and a significant increase in TSH concentrations which in 14 out of 25 (56%) patients reached the hypothyroid level. Baseline TSH values were higher in those patients who developed subclinical hypothyroidism (2.31+/-0.71mU/l vs 1. 34+/-0.64mU/l, P=0.0016). Subclinical hypothyroidism developed in 70% of prepubertal and in 47% of adult patients. Serum ferritin was elevated in all patients. Nine of the fourteen patients (64.3%) who developed subclinical hypothyroidism during iodide administration developed hypothyroidism during the 5-year follow-up compared with only one of the eleven patients with a normal response to iodide (P=0.004). CONCLUSIONS: Patients with beta-thalassemia should not be exposed to excess iodide due to increased sensitivity to its inhibitory effects on thyroid function. The susceptible individuals frequently develop permanent hypothyroidism in the following years.

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The effect of thyroid antibody positivity on reference intervals for thyroid stimulating hormone (TSH) and free thyroxine (FT4) in an aged population

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm.2005.236 ◽

2005 ◽

Vol 43 (12) ◽

Cited By ~ 17

Author(s):

Seija Eskelinen ◽

Pauli Suominen ◽

Tero Vahlberg ◽

Minna Löppönen ◽

Raimo Isoaho ◽

...

Keyword(s):

Reference Intervals ◽

Thyroid Stimulating Hormone ◽

Free Thyroxine ◽

Thyroid Peroxidase ◽

Thyroid Antibodies ◽

Thyroglobulin Antibodies ◽

Thyroid Antibody ◽

Aged Population ◽

Antibody Positivity ◽

Stimulating Hormone

AbstractOur aims were: 1) to analyze the effect of the methodology used to derive clinically feasible cut-off values for thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb), which exhibit highly skewed distributions; and 2) to describe the influence of thyroid antibodies on thyroid stimulating hormone (TSH) and free thyroxine (FT

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Maternal and Newborn Thyroid Hormone, and the Association With Polychlorinated Biphenyls (PCBs) Burden: The EHF (Environmental Health Fund) Birth Cohort

Frontiers in Pediatrics ◽

10.3389/fped.2021.705395 ◽

2021 ◽

Vol 9 ◽

Author(s):

Maya Berlin ◽

Dana Barchel ◽

Anna Brik ◽

Elkana Kohn ◽

Ayelet Livne ◽

...

Keyword(s):

Thyroid Hormone ◽

Polychlorinated Biphenyls ◽

Thyroid Function ◽

Multivariable Analysis ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Hormone Production ◽

Maternal Thyroid ◽

Tsh Levels ◽

Maternal And Newborn

Background: Polychlorinated biphenyls (PCBs) are ubiquitous environmental contaminants found in human tissues. PCBs can be transferred through the placenta and may disrupt the maternal thyroid homeostasis, and affect fetal thyroid hormone production. Several studies have shown that intrauterine exposure to PCBs might be associated with abnormal levels of thyroid hormones in mothers and their offspring.Objectives: To examine the associations between environmental exposure to PCBs and thyroid hormone levels in mothers and newborns.Methods: The EHF-Assaf-Harofeh-Ichilov cohort includes 263 mothers-newborns dyads. A total of 157 mother-newborn dyads had both PCBs and thyroid function measures. Regression models were used to estimate associations between maternal PCB exposure and maternal and newborn thyroid function, controlling for possible confounders.Results: Four PCBs congeners were analyzed: PCBs 118, 138, 153, and 180. ∑PCBs median (IQR) level was 14.65 (2.83–68.14) ng/g lipids. The median maternal thyroid-stimulating hormone (TSH) level was 2.66 (0.70–8.23) μIU/ml, the median maternal free thyroxine (FT4) level was 12.44 (11.27–13.53) μg/dL, the median maternal thyroid peroxidase antibodies (TPO Ab) level was 9.6 (7.36–12.51) IU/mL. Newborns' median total thyroxine (T4) level was 14.8 (7.6–24.9) μg/dL. No association was found between exposure to different congeners or to ∑PCBs and maternal TSH, FT4, thyroglobulin autoantibodies (Tg Ab), TPO Ab and newborn total T4 levels. In multivariable analysis a 1% change in ∑PCBs level was significantly associated with a 0.57% change in maternal TSH levels in women with body mass index (BMI) < 19. The same association was observed for each of the studied PCB congeners. Maternal TPO Ab levels statistically significantly increased by 0.53 and 0.46% for 1% increase in PCB 118 and 153 congeners, respectively. In women with BMI > 25, the association between the PCBs levels and maternal TSH levels was in the opposite direction. No association was found in women with normal BMI (19–24.9).Conclusions: Background exposure to environmentally relevant concentrations of some PCBs can alter thyroid hormone homeostasis in pregnant women and might be associated with abnormal TSH levels and TPO-Ab in women with low BMI. However, these findings require further investigation.

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Environmental Factors Affecting Thyroid-Stimulating Hormone and Thyroid Hormone Levels

International Journal of Molecular Sciences ◽

10.3390/ijms22126521 ◽

2021 ◽

Vol 22 (12) ◽

pp. 6521

Author(s):

Mirjana Babić Babić Leko ◽

Ivana Gunjača ◽

Nikolina Pleić ◽

Tatijana Zemunik

Keyword(s):

Thyroid Hormone ◽

Environmental Factors ◽

Thyroid Hormones ◽

Thyroid Function ◽

Lifestyle Factors ◽

Thyroid Stimulating Hormone ◽

Hormone Levels ◽

Thyroid Hormone Levels ◽

The Impact ◽

Tsh Levels

Thyroid hormones are necessary for the normal functioning of physiological systems. Therefore, knowledge of any factor (whether genetic, environmental or intrinsic) that alters the levels of thyroid-stimulating hormone (TSH) and thyroid hormones is crucial. Genetic factors contribute up to 65% of interindividual variations in TSH and thyroid hormone levels, but many environmental factors can also affect thyroid function. This review discusses studies that have analyzed the impact of environmental factors on TSH and thyroid hormone levels in healthy adults. We included lifestyle factors (smoking, alcohol consumption, diet and exercise) and pollutants (chemicals and heavy metals). Many inconsistencies in the results have been observed between studies, making it difficult to draw a general conclusion about how a particular environmental factor influences TSH and thyroid hormone levels. However, lifestyle factors that showed the clearest association with TSH and thyroid hormones were smoking, body mass index (BMI) and iodine (micronutrient taken from the diet). Smoking mainly led to a decrease in TSH levels and an increase in triiodothyronine (T3) and thyroxine (T4) levels, while BMI levels were positively correlated with TSH and free T3 levels. Excess iodine led to an increase in TSH levels and a decrease in thyroid hormone levels. Among the pollutants analyzed, most studies observed a decrease in thyroid hormone levels after exposure to perchlorate. Future studies should continue to analyze the impact of environmental factors on thyroid function as they could contribute to understanding the complex background of gene–environment interactions underlying the pathology of thyroid diseases.

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